What is carpal tunnel syndrome?

What is carpal tunnel syndrome?

Carpal tunnel syndrome is compression of the median nerve at the level of the wrist. It commonly occurs when tissue around the wrist swell and cause compression of the nerve at the level of the wrist. Symptoms progress over months to years and it’s the most commonly diagnosed neuropathy in the upper extremity.

So about 3 to 6 percent of people are diagnosed with carpal tunnel throughout their lifetime. Slightly more common in women and the median age is about 55 when you’re diagnosed with carpal tunnel.

Symptoms of a carpal tunnel include numbness and tingling of the thumb, index long and part of the ring finger. Patients also get pain in their wrists that sometimes radiates up their forearm. Patients also usually complain of nighttime symptoms that wake them up several times through the night. Extremes of wrist motion cause an increase in symptoms with activities such as driving. These symptoms usually progress over months to years. With end stage disease process, patients can actually get weakness in the thumb with advanced disease.

Carpal tunnel syndrome is a disorder of the wrist and hand that happens when a nerve is pinched in the wrist in an area called the carpal tunnel.

The carpal tunnel is a narrow tunnel formed by bones and tissues in the wrist. It protects your median nerve, which provides feeling to the thumb, index and middle fingers, and controls muscles that move the thumb.

Most cases of carpal tunnel syndrome do not have a definable cause. When swelling occurs in the carpal tunnel, such as during pregnancy or when a patient with arthritis has thickening of the tendons, the increased pressure causes pain and numbness in the wrist and hand, according to the AAFP.

Talk to your doctor for more information about carpal tunnel syndrome.

How is carpal tunnel diagnosed?

Dr. Michael Rymer discusses how carpal tunnel syndrome is diagnosed. Click play to watch the video or read the transcript.

How is carpal tunnel diagnosed?

Carpal tunnel is a clinical diagnosis that we diagnose through a patients history and physical exam. We do often order electrical diagnostic studies that do help, help us diagnose carpal tunnel. The most important this is they also help grade the severity of carpal tunnel syndrome.

Your doctor likely will do two diagnostic tests, according to the NIH, each of which will test for carpal tunnel symptoms by trying to duplicate them:

Tapping or pressing on the median nerve on the inside of the wrist. Your fingers will start to tingle or feel a shock sensation.

Having you bend your wrist down for a minute to see if tingling or numbness starts.

Often, the diagnosis is confirmed by using a nerve conduction test or an electromyography (EMG) test, according to the American Academy of Pediatrics (AAFP). The test determines if the nerves and muscles in your arm and hand show reactions typical of carpal tunnel syndrome.

Talk to your doctor for more information about diagnosing carpal tunnel syndrome.

What puts someone at greater risk for carpal tunnel syndrome?

Dr. Michael Rymer discusses what puts someone at risk for carpal tunnel syndrome. Click play to watch the video or read the transcript.

What places someone at a higher risk for developing carpal tunnel?

Patients are at a higher risk to develop carpal tunnel with certain co morbidities which include diabetes, hypothyroidism, auto immune disease, advanced age and obesity. There’s also a genetic predisposition in certain families for carpal tunnel syndrome, also during pregnancy patients are also a higher risk of developing carpal tunnel syndrome.

Women are at three times greater risk of developing carpal tunnel syndrome than men, according to the National Institutes of Health (NIH). It’s possible this is because a woman’s carpal tunnel is smaller than a man’s.

The disorder usually occurs only in adults, and it typically occurs in the dominant hand first, according to the NIH. Diabetes and other metabolic disorders increase the risk of carpal tunnel syndrome.

While there is no specific job that causes people to develop carpal tunnel syndrome, people who do assembly line work are most likely to suffer from the disorder, according to the NIH.

Some hobbies, such as needlework and canoeing, also can cause symptoms of carpal tunnel syndrome, according to the American Academy of Pediatrics (AAFP).

For more information about what puts someone at risk for carpal tunnel syndrome, talk with your physician.

What is the treatment for carpal tunnel syndrome?

Dr. Michael Rymer discusses the treatment for carpal tunnel syndrome. Click play to watch the video or read the transcript.

What is the treatment of carpal tunnel syndrome?

The treatment of carpal tunnel syndrome is a combination of non operative and operative measures. A lot of it depends on the patients severity of carpal tunnel and what they’ve tried before they see us. Mild carpal tunnel or early on carpal tunnel, we often treat conservatively. That includes modalities such as physical therapy, splinting and anti inflammatories and activity modification. When you get more advanced disease process or disease process that’s not responsive to conservative measures usually we try either steroid injections or surgery.

Some people with mild carpal tunnel, can be managed for the rest of their life with conservative stuff like, splinting, anti inflammatories, activity modification and hand therapy. There is a large proportion that it does progress on to, need an surgical intervention.

To treat carpal tunnel, your doctor will probably ask you to rest your wrist and make an effort to change the way you are doing the movements you suspect are causing the issue, according to the American Academy of Pediatrics (AAFP).

The AAFP recommends the following to help relieve carpal tunnel symptoms:

Avoid overusing your wrist and hand

Do stretching exercises (ask your doctor for some)

Massage the wrist and arm area

Prop your arm up with a pillow, with the elbow at a gentle bend, when you lie down

Try not to hold your wrist in a way that it is bent downward for long

If the carpal tunnel syndrome is mild, your doctor might give you an injection of a corticosteroid in your wrist to help reduce inflammation and pain, according to the AAFP. In more severe cases, surgery might be necessary.

For more information about carpal tunnel syndrome treatment, talk with your doctor.

pain in the side of the thumb and wrist that appears either gradually or suddenly. This pain can travel to the wrist and forearm, and gets worse when the thumb and hand are in use, especially when gripping something tightly or twisting the wrist

snapping sensation felt when moving the thumb

visible swelling on the side of the thumb and the wrist, which could also include a fluid filled cyst

Talk to your doctor for more information about wrist tendinosis symptoms.

How is wrist tendinosis diagnosed?

The test – called the Finkelstein test – is done by putting your thumb against the palm of your hand and making a fist around it with your fingers closed over your thumb, according to the AAOS. You then bend your wrist forward toward your little finger.

If you have wrist tendinosis, this test can be painful to the tendon on the thumb side of your wrist.

For more information about diagnosing wrist tendinosis, talk with your doctor.

anti-inflammatory medication (NSAIDs) – this medication can be taken orally or injected to help reduce swelling and relieve pain

avoiding activities that cause pain – don’t do the things that make your wrist hurt in hopes the symptoms will go away on their own

corticosteroids – having a corticosteroid injection into the tendon sheath can help reduce swelling and pain

hand therapy

splints – wearing splints can help the wrist and the thumb rest

The surgical treatment option is usually recommended if the non-surgical treatments for wrist tendinosis did not help it improve, according to the AAOS. With surgery, the sheath that covers the tendons in the wrist is cut to make more room for the inflamed tendon.

Talk with your doctor for more information about treating wrist tendinosis.

What does arthritis in the hand and wrist feel like? What causes it?

Dr. Cavo discusses what arthritis of the hand and wrist feels like and what causes it. Click play to watch the video or read the transcript.

What does arthritis in the hand and wrist feel like? What causes it?

Arthritis in the hand and wrist often feels like a dull, deep, aching kind of pain. But when certain activities, certain kinds of aggravating activities, such as opening a jar or really powerful grip type of activities, it can actually feel like more of a sharp, stabbing type pain.

Arthritis in the hand and wrist is caused like arthritis pretty much throughout the body by breakdown of the cartilage on the joint surfaces. As that wears away, you get bones rubbing against each other that aren't as smooth as cartilage, so that's what causes the pain. It's a little bit different in the wrist compared to the rest of the hand because the wrist actually can come from a previous injury. A fractured bone or a ligament tear can actually lead to a certain pattern of arthritis

Arthritis of the hand and wrist cause pain and stiffness. It can make activities such as opening a jar or typing on a keyboard painful and difficult.

Are there activities that can put you at higher risk for developing hand and wrist arthritis?

Dr. Cavo discusses activities that can put you at higher risk for hand and wrist arthritis. Click play to watch the video or read the transcript.

Are there activities that can put you at higher risk for developing hand and wrist arthritis?

There aren't really any specific aggravating activities or jobs. There are injuries, like I said, in wrist arthritis that can start the ball rolling toward arthritis. A small bone can get fractured in the wrist. If it doesn't go on to heal, it can lead to early arthritis. A certain ligament in the wrist that's pretty commonly torn, people think it's just a wrist sprain that changes how the wrist moves, it changes the biomechanics of the wrist. That can create some wear on the cartilage surfaces that leads to arthritis.

Though there aren’t specific things you can do that increase your risk for hand and wrist arthritis, injuries can increase your chances of wrist arthritis, according to Premier Physician Network (PPN) physicians.

If you fracture a wrist bone and it doesn’t heal well, it can lead to early arthritis.

A torn wrist ligament that isn’t treated correctly also can lead to wrist arthritis. The tear can cause you to change how you move your wrist, causing the cartilage to wear down, leading to arthritis.

Talk to your doctor for more information about what activities can put you at higher risk for developing hand and wrist arthritis.

What are the treatment options for hand and wrist arthritis?

Dr. Cavo discusses treatment options for hand and wrist arthritis. Click play to watch the video or read the transcript.

What are the treatment options for hand and wrist arthritis?

Nonsurgical treatment may not work for some patients just because of how severe their arthritis is. Once that cartilage is gone, you can't really regrow it. Once the bones are rubbing against each other, it really is a pain generator. Some people are able to benefit quite a bit from nonsurgical steroid injections or bracing different kinds of treatments, but some people, those treatments don't prove effective, and surgery is really the best option.

Steroid injections are like a high dose anti-inflammatory directly to a certain area of the body. Like anti-inflammatories that you take orally, ibuprofen or naproxen, they deliver an anti-inflammatory effect. Those things you take orally go throughout your whole body and affect your kidney, your stomach, everywhere. Whereas corticosteroid or steroid injections are like a high dose, targeted therapy just to one joint of the body. When you give an injection in the knee for knee arthritis, you're getting a targeted therapy just there. Similarly, in the hand, if you give an injection for base of thumb arthritis, you give a small dose of steroid directly where you need it.

Determining the best surgical treatment for a patient with wrist arthritis can depend on what they want to do with their wrist. Some heavy duty laborer type patients need the stability and strength in their wrist, and they don't mind losing some motion. In that situation, we would probably lean more toward what we call a fusion procedure where we make the bones stable and actually act as one long bone. Whereas if someone isn't as heavy lifting type daily activities, they can save their motion and do alternative procedures where we take out the arthritic bone, but we don't fuse the two bones together.

Both surgical and non-surgical treatment options are available if you have hand and wrist arthritis.

Exercise – Use special exercises from your doctor or physical therapist to help with range of motion

Immobilization – Wear a wrist splint for a short time to help support the joint and ease pain during some activities

Medications – Take medicine, such as acetaminophen, naproxen, and ibuprofen to help reduce pain and swelling

Steroid injections – Cortisone is a powerful anti-inflammatory that can be injected into a joint affected by arthritis

Surgical treatments – These are last resort options if non-surgical treatments are no longer helping with pain.

Proximal row carpectomy – The doctor removes three carpal bones to help reduce pain but keep some wrist motion.

Fusion – Your bones of the wrist or finger joint are “welded” together into one solid bone. You will lose motion in your wrist or finger, but the surgery also should stop the pain caused by wrist motion.

Total wrist replacement – Damaged cartilage and bone are removed and replaced with a new plastic or metal joint to help you regain wrist function.

Joint replacement – This procedure will help ease pain and restore function in the hand, as worn cartilage and bone are removed and replaced with plastic or metal parts.

For more information about treatment options for hand and wrist arthritis, talk with your doctor.

What is ring avulsion?

What is ring avulsion?

A ring avulsion injury is when any kind of ring that's on your hand gets stuck on a fast moving object, such as machinery or falling from a ladder, and your ring gets stuck on something and is forcefully pulled off your finger. It can be a devastating injury because it involves stripping away often all of the soft tissue around the bone of your finger.

Most times, a ring avulsion injury happens when your ring gets caught on a fast-moving object, such as a piece of machinery. Or, you can have a ring avulsion injury around your house if your hand gets stuck on something when you, for example, fell from a ladder or roof.

This type of injury can be devastating to your hand, leaving long-term damage to the skin, blood vessels, tendons, bones and soft tissue.

How is ring avulsion treated?

Dr. Matthew Cavo discusses how to treat ring avulsion. Click play to watch the video or read the transcript.

How is ring avulsion treated?

Ring avulsion injuries are very difficult injuries to treat. Often they involve an injury to the blood vessels, tendons, and even the bones of a finger, so pretty much every level of the finger's anatomy is injured. Often times an attempt is made to reconnect all of those different structures. The tendons are repaired, the blood vessels are repaired, the skin is repaired, and the bones are fixed, if possible. Unfortunately, often times, these injuries have to result in a surgical amputation even further back from where the injury started, so that the skin can be closed and you have a functioning hand.

Treating a ring avulsion can be difficult because of the amount of damage the injury can do to your finger’s tendons, bone, blood vessels, and soft tissue, Premier Physician Network (PPN) physicians say.

When a ring you’re wearing gets caught on something and pulled quickly and forcefully, it can cause a ring avulsion. This kind of injury can peel the skin from where the ring would be worn toward the top of your finger.

Doctors can try to repair and reconnect tendons, blood vessels and skin, but many times the injury is too severe to repair. In many cases, a ring avulsion leads to surgical amputation of your injured finger.

To learn more about how a ring avulsion is treated, talk with your doctor.

How can I reduce my risk for a ring avulsion injury?

Dr. Matthew Cavo discusses how to reduce your risk for a ring avulsion injury. Click play to watch the video or read the transcript.

How can I reduce my risk for a ring avulsion injury?

Because ring avulsion injuries are so devastating the most important thing to take away from any kind of education about them is to try and prevent them from happening in the first place. That means taking off your ring whenever working with fast moving equipment or if you have a job that involves working with machinery, always take off your wedding band before starting work. If your wedding band gets caught on anything fast moving, it can result in a ring avulsion injury and lead to permanent damage. It's very quick and easy to prevent it from happening. Take off the ring.

The best way to reduce your risk of a ring avulsion injury is to take off your rings when you’re doing something that they could get caught on.

Whether your job requires you to work with heavy machinery or you’re doing yard work, it’s quick and simple to plan ahead and remove your rings to prevent this kind of injury.

Learn more about reducing your risk for a ring avulsion injury by talking with your doctor.

Who is at high risk for a ring avulsion injury?

Dr. Matthew Cavo discusses who is at high risk of a ring avulsion injury. Click play to watch the video or read the transcript.

Who is at high risk for a ring avulsion injury?

The people that are higher risk for ring avulsion injuries, as you might expect, are the people that work with fast-moving parts and machinery. People at industrial, manufacturing-type jobs that have high powered, high-speed moving parts that a ring could get caught on. Anybody that is working at a height on a ladder or a roof that could potentially fall and get their ring caught on something is potentially at risk for a ring avulsion injury, but the highest risks are those that work with machines.

If you have an industrial or manufacturing job where you work with high-speed moving parts, you are at high risk of a ring avulsion injury, Premier Physician Network (PPN) physicians say.

Wearing a ring increases your risk of it getting caught on the machinery and causing ring avulsion.

Having a job where you spend a lot of time on a ladder and you can fall and catch your ring on something can also increase your risk of a ring avulsion injury.

Talk to your doctor for more information about who is at high risk of a ring avulsion injury.

This website provides general medical information that should be used for informative and educational purposes only. Information found here should not be used as a substitute for the personal, professional medical advice of your physician. Do not begin any course of treatment without consulting a physician.